Skip to main content

Gepants, calcitonin-gene-related peptide receptor antagonists: what could be their role in migraine treatment?

imagePurpose of review Migraine is the second leading cause of years lived with disability after back pain. Poor tolerability, contraindications, drug–drug interactions and efficacy limited to a subpopulation make new approaches necessary for the acute and preventive treatment of migraine. The study of the calcitonin-gene-related peptide (CGRP) pathway over the last decades is a good example of translational medicine leading to directed therapies for patients. Recent findings After some of the first-generation CGRP receptor antagonists, gepants, were not fully developed because of hepatotoxicity, the second generation of gepants have shown efficacy, safety and tolerability in recent clinical trials. Summary Both rimegepant and ubrogepant have published positive randomized placebo-controlled clinical trials data. Vazegepant is the first intranasal gepant for the acute treatment of migraine and has announced a positive phase II/III study. Daily rimegepant use has preliminary data to suggest efficacy. Atogepant has shown efficacy in migraine prevention in a phase II/III study. Most importantly, hepatotoxicity has not been reported in specifically designed phase I studies or long-term extension studies, with rimegepant or ubrogepant, or in a preventive study with atogepant. Given the preventive effect, it seems likely that gepants will not lead to medication overuse headache. They will likely have no cardiovascular warnings. Because of the particular benefit gepants may represent for these groups of patients, specific studies in patients with medication overuse headache, as well as those with comorbid cardiovascular diseases, would be of considerable interest.

from Current Opinion in Neurology - Current Issue https://ift.tt/3dp0oC6

Comments

Popular posts from this blog

Menopause Symptoms Reduced by Cold Water Swimming

Cold water swimming significantly eases menopausal symptoms. Surveying 1114 women, with 785 experiencing menopause, researchers found improvements in anxiety, mood swings, low mood, and hot flushes among participants. from Neuroscience News https://ift.tt/9AqHsEa

Handwriting Boosts Brain Connectivity and Learning

Handwriting, compared to typing, results in more complex brain connectivity patterns, enhancing learning and memory. This study used EEG data from 36 students to compare brain activity while writing by hand and typing. from Neuroscience News https://ift.tt/0bklQBj

More Education, Longer Life: Global Study Reveals Link

A new study reveals that higher education levels significantly reduce the risk of death, regardless of age, sex, location, or background. Researchers found that each additional year of education decreases death risk by two percent, with 18 years of education lowering it by 34 percent. from Neuroscience News https://ift.tt/oeK38Fk